The severity of myocardial ischemia can be predicted by the exercise electrocardiogram

Abstract

The aim of the study was to evaluate the utility of exercise-induced ECG changes in predicting the degree of myocardial ischemia as compared to angiographic and nuclear scintigraphic images. Four hundred and seventy one patients in whom exercise nuclear scintigraphy and coronary angiography revealed significant coronary narrowing (> or =70% luminal diameter narrowing) were studied. Down-sloping ST depression was found to be the best predictor of a large area of reversible ischemia (RI). Time of resolution of ST depression was the second most powerful predictor and the time of onset of ST depression was the third best predictor. RI on nuclear scintigraphy correlated better than angiographic findings with the ECG changes.